tbuckley/cabot-search huggingface dataset:
AB1064 HYPERURICEMIA IN PATIENTS WITH PRIMARY HYPERTENSION: PREVALENCE AND ASSOCIATED FACTORS
Authors: N. El Amri, F. Fhima, D. Khalifa, A. Ben Abdelkrim, B. Ben Abdallah, S. Lataoui, K. Baccouche, E. Bouajina, K. Ach
Journal: Annals of the Rheumatic Diseases (2022)

Background Hypertension and hyperuricemia (HU) are both cardivascular risk factors. HU is frequently associated with hypertension even without the use of treatments that potentially cause elevations of uric acid levels. Objectives To determine the prevalence of HU in patients diagnosed with primary hypertension and its associated factors. Methods A cross-sectional study was conducted in the rheumatology and endocrinology departments of Farhat Hached Hospital of Tunisia over a period of 6 months. Patients diagnosed with primary hypertension were included. HU was defined by uric acid levels ≥ 360 µmol/L in women and ≥ 420 µmol/L in men. Results One hundred patients were included. Study population was mainly made of women (65%). The median of age was 63 years [min:34, max:89]. The prevalence of HU was 26%. HU was more common in women (19%) compared to men (7%) without statistical significance (p= 0.315). The median values of systolic and diastolic blood pressure values were 140 mmHg and 80 mmhg, respectively. Elevated diastolic blood pressure was associated with HU (p=0.043). All patients presented other comorbidities. Type 2 diabetes was the most common one (83%) followed by obesity (56.7%). Forty three percent of patients had dyslipidema, 21% renal failure, 16.9% proteinuria, 9% gout, 8% hypothyroidism and 30% osteoarthritis. HU was significantly associated with hypothyroidism (p=0.027), renal failure (p= 0.000), obesity (p=0.038) and proteinuria (p=0.02). HU was not associated with disturbance of lipid and glycemic status. High uric acid levels were associated with the use of thiazide diuretics (p= 0.048) and ACE inhibitors (p= 0.037). Nonetheless, no association was found with the use of low dose aspirin (p= 0.412) nor other antihypertensive treatments. Conclusion Prevalence of HU is high in patients diagnosed with primary hypertension and is associated with hypothyroidism, obesity, renal failure, proteinuria and diastolic hypertension. HU is also associated with the use of thiazide diuretics and ACE inhibitors. References [1]Clarson LE, Hider SL, Belcher J, Heneghan C, Roddy E, Mallen CD. Increased risk of vascular disease associated with gout: a retrospective, matched cohort study in the UK clinical practice research datalink. Ann Rheum Dis. 2015; 74 (4):642–7. doi: 10.1136/annrheumdis-2014-205252 [2]Deléaval, P., Burnier, M. (2005). ‘L’hyperuricémie dans l’hypertension artérielle: quelle implication?’, Rev Med Suisse 2005; volume -9. no. 032, 2072 - 2079 Disclosure of Interests None declared
POS0820 PREDICTIVE VALUE OF OBJECTIVE EXAMINATION OF TA ON POSITIVITY OF TAB IN GIANT CELL ARTERITIS
Authors: G. Germano, P. Macchioni, G. Klinowski, A. Cavazza, L. Boiardi, C. Salvarani
Journal: Annals of the Rheumatic Diseases (2022)

Background Previous studies have reported the utility of temporal artery examination for the diagnosis of GCA but no data are available on the correlation between clinical examination and the subsequent temporal artery biopsy (TAB) results of the biopsied vessel. Objectives Evaluate the predictive value of temporal artery (TA) examination in patients with suspected GCA on the results of TAB of the same vessel. Methods 97 pts consecutively seen at our center because of suspected cranial arteritis between 01.01.2015 to 31.12.2021 were enrolled in the study. All patients had complete clinical examination, laboratory investigations (included ESR and CRP determination), clinical examination of the temporal arteries and their frontal and parietal branches for tenderness (P), reduced or absent pulse (R) and thickening (T). All patients underwent arterial ultrasound (US) followed by a TAB of the most US involved frontal branches. The presence of inflammatory infiltrate of the vessel wall or the inflammation of the periadventitial blood vessel were considered positive for the presence of arteritis. The clinical features of the biopsied vessel were compared with the histological results by chi square test and the correspondent OR with 95%CI. Sensitivity, specificity, negative and positive PV, negative and positive LR were calculated for every singular objective abnormalities. Results 97 pts entered the study (F 56 (58%), mean age 73 ± 8, biopsy positive 56 (57%). At clinical examination of the biopsied vessel P was reported in 26 cases (27%) of TAB + and 10 (24.4%) in TAB- group (p=0.646, OR 1.24), R in 15 (15.5%) vs 2 (4.9%) (p=0.021, OR 5.69) and T in 16 (28.6%) vs 2 (4.9%) (p=0.003, OR 7.80), anyone (T or P or R) 30 (54.5% vs 11 (26.8%) (p=0.007, OR 3.27), presence of T or R 23 (41.8%) vs 4 (9.8%) (p=0.001, OR 6.65). Sensitivity, specificity, PPV, NPV, PLR, and NLR of any singular objective data and of US examination are reported in Table 1 Table 1. SENS, SPEC, PPV, NPV. PLR, NLR, PRETEST probability, POST TEST probability of clinical objective examination and US results FOR TAB POSITIVITY SENS SPEC PPV NPV PLR NLR PRE POST TA EXAMINATION TENDERNESS (P) 0.286 0.756 0.615 0.437 1.17 0.94 0.57 0.61 REDUCED/ ABSENT PULSE (R) 0.232 0.951 0.867 0.476 4.76 0,80 0.58 0.87 THICKENING (T) 0.286 0.951 0.889 0.494 5.86 0.75 0.57 0.89 ANYONE (P or R or T) 0.545 0.732 0.732 0.545 2.03 0.55 0.57 0.73 R or T 0.418 0.902 0.851 0.536 4.28 0.65 0.57 0.85 US HALO 0.875 0.643 0.636 0.878 2.45 0.19 0.42 0.64 CT+ 0.878 0.654 0.654 0.878 2.54 0.19 0.43 0.65 Conclusion Clinical examination (in particular reduced pulse and arterial thickening) of the temporal arteries is predictive of histological positivity of the TAB. Acknowledgements Gabriella Di Tommaso Disclosure of Interests None declared
AB1153 HYPEREOSINOPHILIC SYNDROME FOLLOWING THE BNT162b2 (BioNTech / PFIZER) VACCINATION
Authors: A. Hoxha, T. Tomaselli, G. Minicuci, G. Scanelli, D. Zardo, L. Naldi
Journal: Annals of the Rheumatic Diseases (2022)

Background Some reports of small vessel vasculitis following nSARS-CoV2 vaccination are reported in the literature (1, 2). Objectives We purpose to report the case of small-medium vessel vasculitis after BNT162b2 (BioNTech/Pfizer) vaccination. Methods We present the case of a 48 years old man with an unremarkable history who underwent BNT162b2 vaccination. Results Five days after the first shot of BNT162b2 vaccine, the patient refer the onset of left inguinal adenopathy, and erythematous dermatitis of the trunk. Ultrasound of the groin found increase bilateral inguinal lymph nodes with reactive characters. Contextually, erythematous, itchy and painful nodular lesions appear in the lower and upper limbs as well as acrocyanosis and paresthesia in the right hand and foot. The tests performed showed thrombocytopenia and eosinophilia. While, CRP, search for fecal parasites, pANCA, cANCA, ANA, RAST test, serum tryptase were all absent. Haematological evaluation, bone marrow biopsy, karyotype and molecular biology (FIP1L1/PDGFRa), were performed, all results negative. The patient was admitted in Internal Medicine ward for worsening of skin lesions and of acrocyanosis with gangrenous lesions at the tips of the fourth finger of the right hand. An angio-CT showed an occlusion of the right ulnar artery. At electromyography an axonal sensory neuropathy was found. The skin biopsy showed fibrinoid necrosis of venules of the superficial vascular plexus associated with numerous eosinophils, lymphocytes and karyorrhetic debris (Figure 1). High-resolution CT scan described diffuse minimal accentuation of the interstitial texture with micronodular aspects and some ground glass appearance. The diagnosis of hypereosinophilic syndrome was made. Therapy with Methylprednisolone 500 mg/daily for 3 days then Prednisone 1 mg/ kg daily in association with IL-5 inhibitor (mepolizumab) with good clinical response, in addition to anticoagulation with warfarin was started. Figure 1. Conclusion To our knowledge this might be the first case of (HES) following COVID vaccine. As our experience, due to the short commercialization of anti-nSARs-CoV2 vaccines, is limited further studies are needed to explore the possible effect on small-medium vessels. References [1]Shakoor MT, Birkenbach MP, Lynch M. ANCA-Associated Vasculitis FollowingPfizer-BioNTech COVID-19 Vaccine. Am J Kidney Dis. 2021 Oct;78(4):611-613. doi:10.1053/j.ajkd.2021.06.016. [2]Altun E, Kuzucular E. Leukocytoclastic vasculitis after COVID-19 vaccination.Dermatol Ther. 2021 Dec 20:e15279. doi: 10.1111/dth.15279. Disclosure of Interests None declared
AB0169 EARLY REMISSION AT 6 MONTHS AS A PREDICTOR OF LONGTERM REMISSION IN NEW ONSET RHEUMATOID ARTHRITIS
Authors: S. Emilie, T. Sokolova, A. Avramovska, P. Sidiras, S. Kleimberg, S. Dierckx, L. Meric de Bellefon, C. Ribbens, M. Malaise, D. R. Silvana, V. Badot, P. Durez
Journal: Annals of the Rheumatic Diseases (2022)

Background Early therapeutic intervention is crucial for patients with early rheumatoid arthritis (ERA). The goal of remission is achievable in a large proportion of ERA patients. Objectives To evaluate the rate of patients in remission at 6 months and to correlate the 36 and 60 months remission rate in the Belgian CAP48 cohort and the UCLouvain Brussels cohort. To identify baseline characteristics differences between patients achieving remission or not. Methods We included patients with ERA from the CAP48 cohort and from the UCLouvain Brussels cohort who met the ACR/EULAR 2010 RA classification criteria. All patients were naïve to csDMARDs therapy. We collected patient characteristics at baseline and clinical response was analysed at 6, 36 and 60 months. Results 287 RA patients from our UCLouvain Brussels Cohort and the CAP48 cohort were analysed (211 Females, 76 Males, mean age 46.2 years, 43.4% with baseline erosion, 70.1% with ACPA, 70.3% with Rheumatoid Factor, mean HAQ 1.16, mean DAS28-CRP 4.67, mean SDAI 24.9 and mean CDAI 24.1). Table 1. The clinical results are summarized in the Table. DAS28-CRPMean(±SD) SDAIMean(±SD) CDAIMean(±SD) Remission(DAS28-CRP), % HAQMean(±SD) Baseline n=287 4.67 (±1.38) 26.5 (±15.5) 24.1 (±14.4) / 1.16 (±0.70) Months 6 n=287 2.97 (±1.34) 11.3(±12.3) 10.5 (±11.8) 44,9% 0.60 (±0.62) Months 36 n=287 2.24 (±1.04) 7.5(±8.6) 6.2 (±7.8) 71,1% 0.52 (±0.59) Months 60 n=196 2.41 (±1.00) 6.4(±6.5) 5.7 (±6.2) 66,3% 0.56 (±0.63) We divided the patients according to whether they achieved remission DAS28-CRP &lt; 2.6 (group 1), or not (group 2) at 6 months. Patient baseline characteristics were similar in the two groups respectively: age (46.7 vs 45.4 yrs); female (68.5 vs 77.3%); smoker (25.6 vs 27.0%); ACPA positive (70.1 vs 75.4%); baseline X-ray erosion (45.0 vs 54.7%). DAS28-CRP, SDAI and CDAI at 6 months could predict long-term remission at 36 and 60 months, Figure: Figure 1. In group 1 global remission (DAS28-CRP&lt;2.6, HAQ&lt;0.5 and no X-ray progression) was observed in 75.6% at 60 months. The majority of these patients (69.4%) are still treated with Methotrexate, the others were treated with combination therapy. Conclusion Early and long term remission is an achievable goal in our two cohorts. Early diagnosis is critical in standard of care. At 6 months, all remission index criteria are good predictor for long term remission and could be used in daily care. Disclosure of Interests None declared
AB1298 AL-AMYLOIDOSIS MIMICKING IgG4-RELATED DISEASE
Authors: B. Chalcev, A. Torgashina, E. Sokol, J. Khvan
Journal: Annals of the Rheumatic Diseases (2022)

Background Hematological diseases such as multiple myeloma (MM) and POEMS-syndrome can be accompanied by high serum IgG4 level and thus mimic an IgG4-related disease (IgG4-RD) [1, 2]. However, there are no descriptions of AL-amyloidosis with increased secretion of IgG4 in the literature. Objectives to present a clinical case of AL-amyloidosis mimicking IgG4-RD. Methods At the age of 42, patient S. developed nasal congestion, and 2 years later bilateral symmetrical swelling of submandibular salivary glands developed. Chest CT scan revealed hydrothorax and pericarditis, interstitial changes in both lungs and intrathoracic lymphadenopathy. According to blood tests, ANF, RF and CRP were within normal values, an increase in the serum IgG4 (32.9 g/l) and IgG (34.1 g/l) levels was detected, and the patient was admitted to our clinic with suspicion of IgG4-RD. Results On examination, we noticed a symmetrical enlargement of submandibular salivary glands and macroglossia. The patient also complained of tingling in the fingers, we performed electroneuromyography and revealed bilateral carpal tunnel syndrome. According to the immunofixation of blood and urine proteins, IgG-lambda paraproteinemia (18,3 g/l) and a trace amount of Bence-Jones-lambda protein in the urine were detected. AL-amyloidosis was suspected and a biopsy of the submandibular salivary gland was performed, followed by Congo red staining and darkfield microscopy that confirmed amyloidosis (Figure 1). There were no signs of IgG4-RD (storiform fibrosis or obliterative phlebitis) in the biopsy specimens. Echocardiography revealed thickening of the interventricular septum and hypertrophy of the ventricular myocardium. MM and other malignancies were excluded on the basis of bone marrow trephine biopsy and PET-CT (also revealed severe hepatomegaly). The diagnosis of IgG4-secreting AL-amyloidosis affecting salivary glands, tongue, heart, lungs, liver, nervous system was made and polychemotherapy was started, the patient’s further life remained unknown. Figure 1. Congo red staining and darkfield microscopy demonstrating amyloid deposits. Conclusion AL-amyloidosis can be accompanied by high serum IgG4 level and mimic IgG4-RD. The serum level of IgG4 should not be used as a criterion for IgG4-RD, and in all cases of suspected IgG4-RD the diagnosis should be confirmed morphologically. References [1]Geyer JT, Niesvizky R, Jayabalan DS, et al. IgG4 plasma cell myeloma: new insights into the pathogenesis of IgG4-related disease. Mod Pathol . 2014;27(3):375-381. doi:10.1038/modpathol.2013.159 [2]Zheng M, Zhou P, Zheng K, et al. A special subtype of POEMS syndrome: IgG4 subtype. Am J Transl Res . 2016;8(2):588-596. Published 2016 Feb 15. Disclosure of Interests None declared
AB0122 DETECTION OF ANTINUCLEAR ANTIBODY AND ANTIBODIES TO EXTRACTABLE NUCLEAR ANTIGENS IN SERUM-DERIVED EXOSOMES
Authors: Y. Huang, Q. Huang, T. W. Li
Journal: Annals of the Rheumatic Diseases (2022)

Background Antinuclear antibody (ANA) and antibodies to extractable nuclear antigens (anti-ENAs) are important diagnostic biomarkers for autoimmune disease. In-direct immunofluorescence (IIF) and EUROLINE-Western Blot technology are used to detect ANA and anti-ENAs in serum respectively. However, the sensitivity of some anti-ENAs are not high, which often lead to the misdiagnosed or missed diagnosis of autoimmune disease. Much more methods are needed to increase the sensitivity of anti-ENAs. The protein of serum-derived exosomes have been used to explore the biomarker of many disease. As the level and significance of ANA and anti-ENAs in serum-derived exosomes, it has not been reported yet. Objectives Our study aims to detect the level of ANA and anti-ENA in serum-derived exosomes and compare the difference between serum and serum-derived exosomes. Methods Twenty-four patients with ANA positive in serum were enrolled into the study. Exosomes were separated from the serum by the ExoQuick TM kit combined with ExoQuick TC kit. ANA and anti-ENAs were further detected by IIF and EUROLINE-Western Blot technology in serum and serum-derived exosomes. Results The ANA levels in serum-derived exosomes were the same as serum. The anti-ENAs levels of serum-derived exosomes in 70% (16/24) patients were different from serum. Besides, anti-nRNP, anti-Sm, anti-SSA, anti-Ro52, anti-SSB, anti-Jo1, anti-CENPB, anti-dsDNA, anti-AHA, anti-ARPA levels of serum-derived exosomes in 11.11% (1/9), 33.30% (1/3), 46.15% (6/13), 54.55% (6/11), 50% (1/2), 100% (1/1), 66.67% (2/3), 75.0% (3/4), 66.67% (2/3), 40% (2/5) patients were different from that of serum. Conclusion The levels of most anti-ENAs in serum-derived exosomes are higher than that of serum, which may help to improve the sensitivity of diagnose in autoimmune disease. References [1]Yáñez-Mó M, Siljander P R, Andreu Z, et al. Biological properties of extracellular vesicles and their physiological functions[J]. Journal of extracellular vesicles, 2015, 4: 27066. Figure 1. The identification and anti-ENAs detection of serum derived exosomes. A: The morphology of EVs were detected by TEM; B: The size of EVs were detected by high sensitivity flow cytometry for nanoparticle analysis; C: The expression of CD81 and TSG101 were detected by western blot; D: The anti-ENAs detection of serum and serum derived exosomes in patient 1#. Disclosure of Interests None declared
AB0106 THE PATTERN OF JOINT INFLAMMATION IN THE CAIA MOUSE MODEL OF ARTHRITIS
Authors: M. Van Mechelen, S. Hayer, K. Van Laere, R. Lories, B. Neerinckx
Journal: Annals of the Rheumatic Diseases (2022)

Background Animal models of inflammatory arthritis such as the collagen-antibody induced arthritis (CAIA) have a variable disease incidence in hind paw arthritis, complicating experimental design. Objectives To investigate the use of 18FDG µPET/CT as a guide for inflammation in joints otherwise inaccessible for clinical scoring, enabling the use of additional joints for histological analysis. Methods CAIA was induced in 8 male DBA/1 mice using the ArthritoMab Antibody cocktail (4 mg/mouse on day 0), followed by 100 µg LPS at day 3. Body weight, clinical signs of arthritis such as paw swelling and grip strength loss were recorded 3 times per week in both front and hind paws. Whole body 18FDG µPET/CT was performed at day 11, the estimated time of peak inflammation, and inflammation was scored visually on images scaled to the same standardised uptake value. At day 28, animals were euthanized and peripheral joints were collected for histological analysis. Results Cumulative disease incidence based on paw swelling dropped from 100% to 87.5% when looking only at hind paws, and to 75% when taking into account only the region suitable for histological analysis, namely the ankle and midfoot of the hind paws. Symmetrical, bilateral hind paw arthritis was not observed. While hind paw arthritis showed a tendency to be less severe in comparison to front paw arthritis, grip strength was equally affected, indicating possible involvement of other hind limb joints. µPET/CT images detected inflammation in the hind paws (at least unilateral involvement in 62.5% of the mice, bilateral involvement in 0%), knee joints (at least unilateral in 75%, bilateral in 50%), hip joints (at least unilateral in 50%, bilateral in 0%), elbow joints (at least unilateral in 50%, bilateral in 37.5%) and shoulder joints (at least unilateral in 25%, bilateral in 25%). Histology could confirm this inflammation with the presence of inflammatory infiltrates and bone erosions. Grip strength loss in hind limbs without paw swelling correlated only weakly with knee inflammation detected by µPET/CT. Conclusion In the CAIA model, inflammatory arthritis can develop in all peripheral joints, in particular with a high incidence in knee joints, which are highly suitable for subsequent histological analysis. Since clinical scoring seems insufficient for detecting these affected joints, implementation of in vivo imaging modalities such as µPET/CT, offers a substantial benefit in disease monitoring and assessment. Disclosure of Interests None declared
AB1177 SEXUALITY, FAMILY PLANNING AND MENTAL HEALTH AMONG REPRODUCTIVE-AGE WOMEN WITH RHEUMATIC DISEASE DURING THE COVID-19 PANDEMIC
Authors: A. Puchner, N. Rosenberg, N. Valenta, V. Ritschl, T. Stamm, P. Mandl, D. Aletaha, K. Rosta
Journal: Annals of the Rheumatic Diseases (2022)

Background Women with rheumatic disease are more likely to suffer from sexual dysfunction, infertility, depression, and anxiety. The pandemic may have affected these constraints. Objectives To investigate the effect of the Covid-19 pandemic on sexuality, family planning and mental health in a sample of women with rheumatic disease. Methods Women aged 18-50 with a rheumatic disease and women in an age-matched healthy control group received questionnaires featuring: 1) demographic information, sexual frequency, family planning; 2) the Female Sexual Function Index (FSFI); 3) the Depression, Anxiety and Stress Scale (DASS-21); and 4) the Coronavirus Anxiety Scale (CAS). Recruitment took place 3/21-12/21. Patients with rheumatic conditions were recruited at the Vienna University Clinic (AKH) and the control group through social media. Parameters were compared between the patients and the healthy control group, and with data on sexuality from women with rheumatic disease from 2019. Results A preliminary analysis was conducted with 83 patients with rheumatic disease and 124 healthy controls. The rheumatic disease group exhibited lower levels of stress (6.46 vs. 8.36 p&lt;0.01) and Coronavirus Anxiety (6.27 vs 7.50 p&lt;0.01) than the control group and was less likely to report that the pandemic led to a reduction of their sexual frequency (p&lt;0.01). The control group cited “stress” frequently the decrease of sexual frequency. The FSFI analysis revealed that patients with rheumatic disease experienced higher levels of pain (p&lt;0.001) during sex than the control group but were more satisfied with their relationships (p&lt;0.05). In comparison to 58 patients with rheumatic conditions, whose data was collected in 2019, the 2021 cohort reported reduced FSFI values in the domains of desire (p&lt;0.01), arousal (p&lt;0.05), lubrication (p&lt;0.05), and orgasms (p&lt;0.01). Conclusion Consistent with research on female sexuality during the pandemic among healthy women, we found that patients with rheumatic conditions reported lower FSFI values in 2021, in comparison to 2019. Our finding that the pandemic had less impact on the patient group than a healthy control group, is consistent with research on MS and IBD patients, who showed surprising resilience in the face of the Covid-19 pandemic. Disclosure of Interests None declared
Differences in definitions and prevalence of hand osteoarthritis: comment on the article by Eaton et al
Authors: Amanda E. Nelson, Todd A. Schwartz, Carolina Alvarez, Yvonne M. Golightly
Journal: Arthritis & Rheumatology (2022)

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